Care Home: 65 Gloucester Crescent

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What the care home does well At the time of this visit the service provided a welcoming, relaxed and friendly atmosphere. Staff were observed to spend time and interact with people throughout this visit, who were also observed to be respectful, attentive and caring. A person surveyed on behalf of a person living in the service said, "The service treats each resident as an individual with their own particular needs". "Each individual is treated with care and compassion and the staff manage to make the residents feel really cared about, happy and secure". The service has made progress with updating their person centred care plans, which contain detailed information about people`s likes, dislikes, preferences, routines, choice and decision making. People are involved with choosing the weekly menu, which meets their dietary needs, preferences and culture. What has improved since the last inspection? Since our previous visit the service has reviewed and updated their person centred care plans and health action plans, which now reflect the current needs of people living in the service The service has now implemented robust procedures, which ensures that staff are now of aware of their reporting responsibilities to the Commission and other agencies. The service has updated their quality assurance feedback surveys, which have been provided to relatives and staff to gain their views. What the care home could do better: The registered provider must submit an application to the Care Quality Commission to register a manager. The service must continue to ensure that the staffing numbers provided in the service are sufficient to meet the needs and dependency levels of people living there. Key inspection report Care homes for adults (18-65 years) Name: Address: 65 Gloucester Crescent 65 Gloucester Crescent Laleham Middlesex TW18 1PN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Lisa Johnson     Date: 1 7 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 65 Gloucester Crescent 65 Gloucester Crescent Laleham Middlesex TW18 1PN 01784421407 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): r.donnelly@owl-housing.org Dimensions (Owl) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 65, Gloucester Crescent is a home for six adults with learning disability. The home is owned by Owl Housing Ltd. The home offers accommodation for single occupancy with bedrooms on the ground and first floor of the detached property. Car parking is available at the front of the building. Current fees range from £1,440- £1,462.07 Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 6 0 8 1 0 2 0 0 9 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced site visit was part of a key inspection. We arrived at 9:35am and left at 4:00 pm. The last key inspection was carried out 8th October 2009. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment. (AQAA). This is a self-assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA by the expected date,which was clear, detailed and gave us all the information we asked for. Reference is made to this assessment throughout this report. We sent out surveys to people living in the service and one was returned to us that had been completed by their representative on their behalf. Care Homes for Adults (18-65 years) Page 5 of 27 During this visit discussion took place with the person in charge of the home and four members of staff. We also received feedback surveys from four members of staff. During this visit we looked at the requirements that were made at the last inspection to see if these had been met. During this visit we spent time some time observing activities and staff interaction. We sampled staff recruitment, and training records, care plans, risk assessments, menus, complaint, accident/ incident records, quality assurance systems, administration policies, health and safety records and policies and procedures. We also reviewed other information that we have received since our previous visit including notifications. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their representatives are provided with accessible information so they can make an informed decision about whether the home will be able to meet their needs. Peoples needs would be assessed prior to admission to ensure that the service will be able to meet them. Evidence: During this visit we looked at the information provided to people who use the service to see whether it is able to supply everything that people or their representatives need to know. The service provides a statement of purpose and service guide, which is accessible to people with pictures and includes current and detailed information about the services that they are able to provide. Since our previous visit there have been no admissions and there is one vacancy. People currently residing in the service have lived there for a number of years. The service has an admission procedure and information supplied in the AQAA states that new potential people would have a full assessment of their needs. Care Homes for Adults (18-65 years) Page 9 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples assessed and changing needs and personal goals are reflected in their individual plan of care. People are supported to make decisions about their lives and they are supported to take risks as part of an independent lifestyle. Evidence: Since our previous visit the service has made progress in reviewing and updating all peoples care plans. Each individual has a person centred support plan and work book in place, which includes an action plan. These now provide a clear overview of peoples support needs and goals. Information supplied in the AQAA states that staff are trained in person centred awareness. Peoples care reviews are attended by the person if they wish to,relatives, key workers, care managers and health care professionals. The service was advised to ensure that systems are put in place to record when care plan reviews are due to be completed by the service and to document the outcome to ensure that these are kept up to date. Each person has a key worker and staff spoken with during this visit told us that they Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: had been involved in the development of the care plan and demonstrated their understanding of peoples needs. The service maintains detailed daily records, which includes information about peoples personal and health care, activities, diet, medication, communication, behaviours and sleep patterns. The service is demonstrating that they are supporting people to make decisions and choices about their lives and providing assistance where this needed. The service holds a weekly meeting where people are supported to make the agenda. People are involved in planning holidays and weekends to reflect their choice of location. Staff recruitment now takes place in the service, which allows people living in the service to be involved in meeting the applicants and for monitoring of interactions between them and candidates. Since our last visit the service has begun implementing pictorial staff duty rotas to assist people in identifying who is on duty. People living in the service have limited verbal communication and care plans documented peoples methods and means of communication. During this visit we observed staff to respond to these effectively. A person living in the service has recently been assessed by a Speech and Language Therapist to identify objects of reference that can be used to increase communication with them. Since our previous visit the service has reviewed and updated all of their risk assessments, which had been read and signed by staff to confirm their understanding. Risk assessments sampled included, community access and activities, use of the kitchen, epilepsy with supporting guidelines, trips and falls and access of the stairs and epilepsy, which provided clear guidance for staff to follow. Care Homes for Adults (18-65 years) Page 11 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is demonstrating that they are exploring and developing a range of meaningful vocational, educational, recreational, social and leisure needs for people to participate in. Peoples cultural and diverse needs are respected and they maintain contact with their family and friends. People are supported to exercise choice over their lives and they are provided with varied and well balanced meals. Evidence: Since our previous visit the service has made progress by exploring some new activities for people to participate in. Each persons care plan now contained an updated activities schedule. One person is supported to attend the organisations office to participate in employment. Some people have joined a community one to one group where they can take part in social events such as discos. During this visit we saw two people go out shopping and visit the cafe with staff. People have acquired bus passes and visits to places of interest take place. One persons care plan identified Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: that one of their goals is to go on a train trip, which is being pursued. One person likes to regularly visit a local coffee shop. People also use other local facilities such as visiting the barbers and going to the bank with staff. Another persons care plan identified that they receive aromatherapy and the service is planning to look at further education opportunities if people would like to attend . Information supplied in the AQAA states that relationships with family and friends are promoted. People receive visits in the service and visit their relatives at their home. Peoples care plans contained detailed information about how they are to be supported to make choices such as choosing their preferred meals and favourite clothing. One persons plan identified that their preference is to wear a jumpers, which they were seen wearing during this visit. During this visit people were seen accessing the kitchen and staff were observed to be interacting well with people who were seen offering them good support and choices with their lunchtime meal. Menus are planned on a weekly basis by people and they are supported by staff to take in account their different dietary needs as well as individual preferences. The home is in the process of introducing picture exchange cards (PECS) to assist in this process. Menus were observed to be well balanced and varied. We were informed that three people receive input from the dietitian and another person enjoys eating meals which reflect their cultural background. Care Homes for Adults (18-65 years) Page 13 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive their personal support in the way they prefer and their health needs are met. The service supports people with their medication in a safe way. Evidence: Since our previous visit peoples health action plans have been reviewed and updated, which outline their personal, health, emotional needs. Peoples care plans detail their likes and dislikes and preferred routines such as times of getting up and going to bed. Care plans included clear guidelines as to how peoples personal and health needs were to be supported. The service supports some older people and their mobility needs have been considered that are supported by risk assessments. Another person was identified as suffering frequent seizures. The service has implemented a detailed risk assessment, which includes guidance for staff to follow both during the day and at night time. Information seen during this visit indicated that people are supported by a range of health and social care professionals including, General Practitioner, community nurse who is a specialist in supporting people with dementia, dietitian, chiropody and dental Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: services.We were informed that one person dislikes leaving the house , therefore arrangements are made for this person to receive consultations within the home. Health action plans sampled indicated that peoples health screening checks and appointments are being updated and records were maintained of any health care consultations such as visits. Staff receive specialist training ensuring that they are able to support the specialist health needs of people living in the service including dementia awareness which was confirmed by staff training records and discussion with staff at the time of this visit. Although some staff have received epilepsy awareness training updates the manager is in the process of arranging updated training for all staff ensuring that they are able to meet peoples needs. During this visit staff were observed to be attentive, caring and addressed people respectfully. A member of staff was observed knocking on a persons door before entering respecting their privacy. People were observed to be appropriately dressed and clean. A survey received completed by a relative on behalf of a person living in the service said, The service treats each resident as an individual with their own particular needs. Each individual is treated with care and compassion and the staff manage to make the residents feel really cared about, happy and secure. The homes medication administration practises were examined. The medication was stored and locked away safely. Medication is dispensed by the chemist using the monitored dose system (MDS). Medication administration records were sampled for four people that were were appropriately maintained and recorded. All quantities of medication received by the home were recorded and disposal records were maintained. Each medication administration record contained a photograph of the person for identification and profiles were in place. People currently living in the service are unable to self administer their medication and their preferred ways of receiving their medication was documented. Care Homes for Adults (18-65 years) Page 15 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns they know how to complain. The home safeguards people from abuse. Evidence: During this visit we looked at information provided to people, which tells them about how they can make complaints.We saw a copy of the homes complaints procedure, that included the timescale for investigating any complaints. The procedure has been made accessible to people with the inclusion of pictures and symbols. The procedure was also observed displayed in peoples bedrooms. The service maintains a complaints register, which we viewed during this visit and no complaints have been received by them since our previous visit. The service has safeguarding vulnerable adults from abuse procedures in place including, the local authority multi agency procedure, which they have now obtained. Information supplied in the AQAA states that all staff have received safeguarding vulnerable adults from abuse training apart from two members of staff who have been booked to attend. During this visit we sampled three members of staffs training records and discussion with four members of staff confirmed this. Since our previous visit the manager has carried out training with staff to raise their understanding and knowledge of reporting procedures. The service is now demonstrating through their accident/incident records and notifications that they have Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: provided to the Care Quality Commission that they are now aware of the procedures,which must be followed. Discussion was held with four members of staff confirmed that they were aware of their responsibilities should they ever witness or be made aware of any incident where the safety of people is compromised. Since our last visit there have been no matters referred following the local authority safeguarding vulnerable adults from abuse procedures. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and well maintained home that is homely,comfortable,clean and hygienic Evidence: The home is situated in a residential area and provides a spacious and homely environment. The home has an open plan dining room/kitchen and there are two sitting rooms. Continuous improvements are being made to improve the decoration and furnishings. Over the last year new curtains, carpets, flooring, bedrooms have been repainted, kitchen equipment has been replaced and a new washing machine has been purchased. Internal monthly visits are carried out to monitor maintenance issues, the condition of the house and garden and health and safety checks are conducted. During this visit we observed that a ceiling in one of the sitting rooms had a patch,which requires repair, although the service is currently attending to this. An accessible shower room is available on the ground floor to meet peoples needs. There is a well maintained accessible garden to the rear of the property. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: Bedrooms viewed were comfortable and we were informed that one person assisted by a member of staff has redecorated their bedroom. Another persons bedroom door has been painted in colours that assist them to identify their room. During this visit the home was seen to be clean and hygienic. A person is employed by the service during the week to carry out cleaning tasks. Since our previous visit the service has received an inspection from environmental health to look at their food hygiene standards. Recommendations made by them have been completed. Appropriate hand washing facilities and equipment were available and staff receive training in infection control. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are in the main supported by sufficient staffing levels, but the service needs to keep the staffing levels under review to ensure peoples safety and welfare. The service is demonstrating that people using the service are supported by staff that are competent and mainly trained to meet their needs. People living in the service are protected by the homes recruitment policies and practises. Evidence: Information supplied in the AQAA states that recruitment has improved. Two new members of care staff are due to commence employment shortly,which will result in the service having its full compliment of care staff. The service continues to employ agency who have worked in the home on a regular basis and know peoples needs well, although agency hours are being reduced as the numbers of permanent staff increase. The AQAA states that the rota is arranged flexibly to meet peoples needs. At the time of this visit there were two members of staff on duty and a third member of staff arrived later in the morning to support people to attend activities. After our previous visit staffing numbers were increased this included the provision of a sleep in member of staff in addition to a waking night member of staff. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: Recently one person has now moved from the home therefore the service has now ceased the sleep in arrangement. There are now four people living in the home who are supported by one waking night member of staff and on call back up arrangements are in place should extra staff support be required.We were informed that there is a lone working procedure in place. However it is required that the service continues to ensure that sufficient staffing levels provided based on the current dependency levels of people living there ensuring their safety and wellbeing. One person receives additional funded hours to support them to attend activities and an application is being submitted for these hours to be increased as they require additional support with personal care. Information supplied in the AQAA states that three out of seven carers employed in the service have obtained National Vocational Qualifications (NVQ Level 2) or above and a new member of staff who is due to commence employment shortly also holds an NVQ (Level 2) New staff receive induction and are registered on to the Learning disability qualification (LDQ), which they must complete before their probation period is completed. The person in charge has updated staff training schedules, which were placed in members of staff personal files, which confirmed that staff receive updated statutory training and specialist training including dementia awareness. The service has identified that they need to ensure that staff receive up to date training in epilepsy, which must be completed. Four members of staff spoken with at the time of this visit told us about the range of training that they have attended. Four members of staff surveyed said that they feel they have enough support, experience and knowledge to meet the needs of people living at the service. Staff recruitment is based on equal opportunities. During this visit we sampled three members of staff personal files. Records were in place confirmed that the required information including, completed application form, two written references and enhanced criminal records bureau checks (CRB) is gained prior to any person commencing employment in the service. Information supplied in the AQAA states that they receive supervision every four to six weeks. Staff spoken with during this visit said that they receive staff regular, formal supervision and four members of staff surveyed also confirmed this. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current person in charge has the experience and competencies to run the home, although an application needs to be made to register a manager.The service is developing quality assurance systems and peoples health and safety is protected. Evidence: Since our previous visit we were informed that the registered manager is no longer in post. The person currently managing the home has been working there since January 2009. The person in charge has obtained National Vocational Qualifications Level (3&4) and that they have also obtained the Registered Managers Award. Information supplied in the AQAA and seen during this visit confirmed that the person in charge has received statutory and specialist training The organisation has carried out a recruitment exercise to appoint a permanent manager but this was unsuccessful. Discussion took place at the time of this visit with the organisations area manager that they are required to make arrangements for a person to apply to the Care Quality Commission to register with us. Since this visit we have been informed that the organisation is planning to provide a manager from Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: another service within the organisation to manage the home. The Annual Quality Assurance Assessment (AQQA) provided to us contained clear information about the improvements that have been made and where further improvements are needed. Members of staff spoken with during this visit said that felt supported by the current management arrangements in the home, regular staff team meetings take place and some improvements have taken place. A member of staff surveyed said, The service has a great team. The registered provider carries out monthly quality monitoring visits, although not all of the reports were available in the home. However the organisations area manager obtained these from their head office, which confirmed that these visits had taken place except for one month. Management were advised to ensure that these reports be maintained in the home at all times to be available for inspection. The area manager assured us that they would follow up this matter as this had been highlighted at the last inspection. Since our previous visit the service has updated their quality feedback surveys by gaining the views of peoples relatives and staff, which we viewed at the time of this visit. The service has also implemented feedback questionnaires to gain the views of visitors attending the home. Systems were in place ensuring the safety and well being of people living in the service including, regular health and safety checks, regular water temperature monitoring and regular servicing and maintenance of equipment. Environmental risk assessments have been carried out and substances hazardous to health were stored away safely. Staff training records sampled indicated that they receive statutory training including moving and handling, first aid, food hygiene and health and safety. The service now has a robust system in place for reporting accident and incidents and they have provided. notifications to us about information that we know about required by the legislation. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 33 18 The registered person must continue to ensure that there are sufficient numbers of persons working in the care home at all times This is to ensure the health, welfare and safety of people living in the service. 23/04/2010 2 37 8 The registered person must 17/05/2010 appoint a person to manage the service and ensures this person submits an application for registration to the Care Quality Commission. This is to ensure that the home is run by a person fit to do so. Care Homes for Adults (18-65 years) Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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